Resting Energy Expenditure Is Elevated in Asthma.

Jacob T Mey,Steven B Heymsfield,Laura Peterson,Serpil C Erzurum,Catherine M Champagne,Mark Aronica,Suzy A A Comhair,Kristin K Hoddy,Brittany Matuska,Sarah Micklewright,Peng Zhang,Anny Mulya,Emily Pennington,Jacqueline Sharp,Stephanie Mccarroll,Michelle Koo,Patrick Wyszynski,John P Kirwan

doi:10.3390/nu13041065

Abstract

Background: Asthma physiology affects respiratory function and inflammation, factors that may contribute to elevated resting energy expenditure (REE) and altered body composition. Objective: We hypothesized that asthma would present with elevated REE compared to weight-matched healthy controls. Methods: Adults with asthma (n = 41) and healthy controls (n = 20) underwent indirect calorimetry to measure REE, dual-energy X-ray absorptiometry (DEXA) to measure body composition, and 3-day diet records. Clinical assessments included spirometry, fractional exhaled nitric oxide (FENO), and a complete blood count. Results: Asthmatics had greater REE than controls amounting to an increase of ~100 kcals/day, even though body mass index (BMI) and body composition were similar between groups. Inclusion of asthma status and FENO in validated REE prediction equations led to improved estimates. Further, asthmatics had higher white blood cell (control vs. asthma (mean ± SD): 4.7 ± 1.1 vs. 5.9 ± 1.6, p < 0.01) and neutrophil (2.8 ± 0.9 vs. 3.6 ± 1.4, p = 0.02) counts that correlated with REE (both p < 0.01). Interestingly, despite higher REE, asthmatics reported consuming fewer calories (25.1 ± 7.5 vs. 20.3 ± 6.0 kcals/kg/day, p < 0.01) and carbohydrates than controls. Conclusion: REE is elevated in adults with mild asthma, suggesting there is an association between REE and the pathophysiology of asthma.

Highlights

Asthma is a syndrome of airway inflammation and airflow obstruction and is one of the most common chronic diseases in the United States [1]
Asthmatics showed a trend toward a lower percentage of predicted Forced vital capacity (FVC) (p = 0.05) and forced expiratory volume in 1 s (FEV1) (p = 0.08), but fractional exhaled nitric oxide (FENO) was similar among asthmatics and controls
Asthmatics had a higher incidence of nasal polyp (p = 0.01), bronchitis history (p = 0.04), and allergy (p = 0.04) than healthy controls

Summary

Introduction

Asthma is a syndrome of airway inflammation and airflow obstruction and is one of the most common chronic diseases in the United States [1]. Airway smooth muscle and epithelial cells and platelets from asthmatics have increased mitochondrial respiration [4,5], while murine models of asthma show changes in bioenergetics [4,6,7]. Evidence from both preclinical models [8] and children [9,10] suggests that asthma increases resting energy expenditure (REE), potentially contributing to a negative energy balance and delayed or impaired growth [11,12]. Conclusion: REE is elevated in adults with mild asthma, suggesting there is an association between REE and the pathophysiology of asthma

Objectives

Methods

Results

Conclusion